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肺黏液腺癌:一例报告及文献综述

Pulmonary mucinous adenocarcinoma: A case report and literature review.

作者信息

Qian Minghui, Lyu Ruibing, Xiao Long, Shi Benqi, Liu Nian, Yuan Yaqian, Wang Wenju, Li Xin

机构信息

Department of Respiratory and Critical Care Medicine, CR&WISCO General Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, Hubei Province, China.

Clinical Medical College, Wuhan University of Science and Technology, Wuhan, Hubei Province, China.

出版信息

Medicine (Baltimore). 2024 Dec 27;103(52):e41161. doi: 10.1097/MD.0000000000041161.

DOI:10.1097/MD.0000000000041161
PMID:39969302
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11688088/
Abstract

RATIONALE

Pulmonary mucinous adenocarcinoma (PMA) is a rare subtype of lung adenocarcinoma. Computed tomography images of PMA show pneumonia-like findings, solitary pulmonary nodules or ground-glass opacity with consolidation. Misdiagnosis can delay genetic diagnosis. This article reported a case of PMA presenting with unique imaging findings.

PATIENT CONCERNS

An 85-year-old female patient was admitted to our hospital with persistent-cough and expectoration. Anti-infection treatment was largely ineffective.

DIAGNOSES

Bronchoscopy with bronchoalveolar lavage and liquid-based cytology revealed the presence of tumor cells. Lung biopsy confirmed the diagnosis of PMA.

INTERVENTIONS

Symptomatic treatment was administrated, including anti-infection, relief of cough and expectoration. Bronchoscopy and lung puncture were performed to help clarify the cause of the disease.

OUTCOMES

The patient's course was uneventful, and she was discharged in good condition. After admission, the patient continued to receive anti-tumor immunotherapy in the oncology department.

LESSONS

PMA is a subtype of lung adenocarcinoma and has a low incidence. PMA usually presents with atypical clinical symptoms and signs, and it is difficult to be diagnosed based on imaging findings. It is often undiagnosed and misdiagnosed. Clinicians must increase awareness about the need for timely diagnosis, so as to develop more targeted treatment and achieve a better prognosis.

摘要

理论依据

肺黏液腺癌(PMA)是肺腺癌的一种罕见亚型。PMA的计算机断层扫描图像显示出肺炎样表现、孤立性肺结节或伴有实变的磨玻璃影。误诊会延误基因诊断。本文报道了一例具有独特影像学表现的PMA病例。

患者情况

一名85岁女性患者因持续咳嗽、咳痰入院。抗感染治疗效果不佳。

诊断

支气管镜检查及支气管肺泡灌洗和液基细胞学检查发现肿瘤细胞。肺活检确诊为PMA。

干预措施

给予对症治疗,包括抗感染、止咳祛痰。进行支气管镜检查和肺穿刺以协助明确病因。

结果

患者病情平稳,康复出院。入院后,患者继续在肿瘤科接受抗肿瘤免疫治疗。

经验教训

PMA是肺腺癌的一种亚型,发病率较低。PMA通常表现为非典型的临床症状和体征,难以根据影像学表现进行诊断。其常未被诊断或误诊。临床医生必须提高对及时诊断必要性的认识,以便制定更有针对性的治疗方案并获得更好的预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f89/11688088/8116a3ef7404/medi-103-e41161-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f89/11688088/c89a84b25b3a/medi-103-e41161-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f89/11688088/99df7dcd7768/medi-103-e41161-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f89/11688088/8116a3ef7404/medi-103-e41161-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f89/11688088/c89a84b25b3a/medi-103-e41161-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f89/11688088/99df7dcd7768/medi-103-e41161-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f89/11688088/8116a3ef7404/medi-103-e41161-g003.jpg

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Heliyon. 2024 Mar 29;10(9):e28881. doi: 10.1016/j.heliyon.2024.e28881. eCollection 2024 May 15.
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Invasive mucinous adenocarcinoma misdiagnosed as pneumonia: A case report.侵袭性黏液腺癌误诊为肺炎:一例报告。
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Invasive mucinous adenocarcinoma of the lung.肺浸润性黏液腺癌
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Comprehensive Molecular and Clinicopathologic Analysis of 200 Pulmonary Invasive Mucinous Adenocarcinomas Identifies Distinct Characteristics of Molecular Subtypes.200 例肺部浸润性黏液性腺癌的全面分子与临床病理分析确定了分子亚型的独特特征。
Clin Cancer Res. 2021 Jul 15;27(14):4066-4076. doi: 10.1158/1078-0432.CCR-21-0423. Epub 2021 May 4.
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Comprehensive analysis of the clinicopathological features, targetable profile, and prognosis of mucinous adenocarcinoma of the lung.全面分析肺黏液性腺癌的临床病理特征、可靶向特征和预后。
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